MEDIM 2GM INJECTION

Indications

• Moderate to severe pneumonia
• Urinary tract infections
• Skin and soft tissue infections
• Intra-abdominal infections
• Febrile neutropenia
• Bacterial meningitis

Dosage

Children: Refer to specific clinical guidelines and local protocols as dosing may vary based on the condition being treated and patient characteristics.

Adults: Refer to specific clinical guidelines and local protocols as dosing may vary based on the condition being treated and patient characteristics.

Mechanism of action

Cefepime works by inhibiting bacterial cell wall synthesis, leading to cell lysis and death. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, disrupting the transpeptidation process that is essential for cell wall structural integrity.

Pharmacodynamics

Cefepime exhibits time-dependent antibacterial activity, meaning that its efficacy is related to the duration of time the drug concentration remains above the minimum inhibitory concentration (MIC) for the target organism. The drug possesses a broad spectrum of activity, including efficacy against Pseudomonas aeruginosa and Enterobacter species, making it effective for empirical therapy in febrile neutropenia and other infections.

Pharmacokinetics

Cefepime is administered intravenously or intramuscularly, with a bioavailability of nearly 100%. It is widely distributed in body tissues and fluids and can penetrate the blood-brain barrier. The drug is primarily eliminated by the kidneys, with approximately 85% of a dose excreted unchanged in urine. Its half-life is approximately 2 hours in individuals with normal renal function, which can be prolonged in patients with renal impairment.

Contra-indications

• Hypersensitivity to cefepime or other cephalosporins
• History of severe allergic reactions to penicillins

Adverse effects

• Diarrhea
• Nausea
• Vomiting
• Rash
• Severe allergic reactions
• Neutropenia
• Seizures (in cases of renal impairment or high doses)

Interactions

• Probenecid may increase cefepime levels due to decreased renal clearance
• Potential increased risk of nephrotoxicity when used with other nephrotoxic agents

Precautions

• Use with caution in patients with renal impairment, dosage adjustment may be necessary
• Monitor for signs of allergic reactions, particularly in patients with a history of penicillin allergy
• Cefepime should be used cautiously in patients with a history of gastrointestinal disease, particularly colitis

Pregnancy

Cefepime is categorized as pregnancy category B. Animal studies have not shown any harm to the fetus, but there are no well-controlled studies in pregnant women. Use only if clearly needed.

Breast-feeding

Cefepime is excreted in breast milk in small amounts. Caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from light and moisture. Reconstituted solutions should be used promptly or stored as directed by the manufacturer.

Formulations

• Injection: cefepime for injection in vials
• Powder for injection: cefepime in lyophilized form